Kornimate/medical-research-clean huggingface dataset:
microbiology testing with the aim of directed antimicrobial therapy for cap

Conditions: Community-acquired Pneumonia

Summary: this is a prospective interventional study to assess laboratory testing which will identify the microbial cause of pneumonia. this, in turn, will allow targeted antimicrobial agent selection for patients with community acquired-pneumonia (cap). hypothesis: 1) to determine if targeted strategy is non-inferior to empiric therapy with respect to outcome endpoints. 2) to assess the use of innovative poc tests allows targeted narrow-spectrum antimicrobial therapy. 3) to determine if targeted strategy is superior to empiric therapy in patients with viral pneumonia

the study will be conducted at five academic medical university sites with 7 hospitals. empiric therapy is defined as selection of antibiotic therapy based on the 2007 ats-idsa guidelines in which broad-spectrum antibiotics are recommended, and microbial cause is uncertain

Eligibility criteria:
inclusion criteria: ● adult patients greater than age 17 years who are initially evaluated in the ed with symptoms of cap. this includes those who will be treated as outpatients and those admitted to the hospital (both ward and icu). the definition of cap is as follows: * presence of pulmonary infiltrates on chest radiography. (initial reading may be performed by the ed physician - but has to be confirmed by board certified radiologist for inclusion in the study). * at least 2 of the following: new onset of cough, productive sputum, shortness of breath, chest pain, fever \> 380c, abnormal chest auscultation, wbc \> 12,000 cells/ml. * able to provide informed consent * read, signed, and dated informed consent document * available for follow-up for the planned duration of the study exclusion criteria: * patients with underlying immunosuppressive illness (hiv, neutropenia, asplenia, transplant recipient, cystic fibrosis, receipt of immunosuppressive medications including corticosteroids, (equivalent of prednisone \> 10 mg) cancer chemotherapy, or anti-tumor necrosis factor agents. * patients residing in long-term care facilities

Keywords: community-acquired pneumonia targeted strategy empiric therapy
cost-effectiveness of two painkillers for treating pain after limb injuries

Conditions: Soft Tissue Injuries

Summary: background: paracetamol and non-steroidal anti-inflammatory drugs (nsaids) such as ibuprofen are commonly used oral analgesics in emergency departments (ed) not only in hong kong but throughout the world. there are no large-scale (n\>100), prospective, randomised studies comparing paracetamol with ibuprofen in the management of acute soft tissue injury. as paracetamol is cheaper than most nsaids, may be as effective in the management of acute pain and possibly with fewer adverse effects, a large-scale, randomised, controlled trial is needed to answer questions of relative analgesic efficacy, safety and cost-effectiveness. previous comparative studies on nsaids have been done in this unit and have suggested equivalence between two nsaids and paracetamol, but numbers were small and drug doses were modest. objective: to compare the efficacy, safety and cost between oral ibuprofen and paracetamol in pain control for acute soft tissue injuries in an ed setting design: prospective, double-blind, randomised controlled trial with three arms: oral paracetamol with placebo; oral ibuprofen with placebo; paracetamol and ibuprofen in combination participants: 783 subjects having sustained isolated soft tissue limb injury without significant fracture presenting to the ed of prince of wales hospital main outcome measures: pain relief profiles of paracetamol, ibuprofen and the combination of both; adverse effect profiles of paracetamol, ibuprofen and the combination of both; overall cost effectiveness of paracetamol, ibuprofen and the combination of both from the perspective of the healthcare provider


Eligibility criteria:
inclusion criteria: * all patients \>16 years presenting to the ed with isolated soft tissue injury without significant fracture * between 9am to 5pm, monday to friday, exclusion criteria: * history of : * peptic ulceration or hemorrhage * recent anticoagulation * pregnancy * adverse reaction to paracetamol or ibuprofen * renal or cardiac failure * hepatic problems * rectal bleeding * chronic nsaid consumption * asthma * chronic obstructive pulmonary disease * chronic pain syndromes * prior treatment with analgesia for the same injury * physical, visual or cognitive impairment making use of the visual analogue scale unreliable

Keywords: soft tissue injuries
comparison of clinical outcomes of ivus -guided and angiography-guided pci in patients with acute stemi

Conditions: ST Elevation Myocardial Infarction

Summary: to compare the long-term clinical outcomes of ivus-guided vs angiography-guided pci in patients with acute stemi

this study is a prospective, multicenter, randomized controlled trial, led by the second hospital affiliated to zhejiang university school of medicine, a total of 10 hospitals in zhejiang province interventional cardiovascular center to participate in, plan to recruit 200 stemi patients. subjects according to the proportion of 1:1 were randomly allocated to two treatment groups.(experimental group (ivus) steering group or control group (imaging) steering group.) plan 10 centers in 200 men and women aged 18 and older patients, according to the american heart association and the united states the college of cardiology interventional treatment guidelines for the participants. each center recruiting number does not exceed 40% of the total plan recruitment.

Eligibility criteria:
inclusion criteria: -clinical inclusion (ci) criteria: ci. age \> 18 years c2. onset of stemi \> 30 minutes, but \< 12 hours c3. st segment elevation in at least 2 contiguous leads of≥ 1mm or newly developed lbbb on ecg c4. willing and able to provide informed consent * angiographic inclusion (ai) criteria (visual estimate) ai1. having at least one infarct-related coronary artery of which * the culprit lesion is suitable for stenting * the reference diameter of culprit vessel is ≥ 2.5 mm but ≤ 4 mm * the timi flow is ≤ 1 in culprit lesion segment prior to guide wire crossing ai2. no excessive tortuosity and calcification in the culprit lesion segment that allowing stent implantation exclusion criteria: * clinical exclusion (ce) criteria ce1. contraindicating to any concomitant study medications ce2. having cardiogenic shock with hemodynamic instability ce3. a history of bleeding diathesis or known coagulopathy ce4. a history of cerebrovascular accident (cva) or transient ischemic attack (tia) within the past 6 months; or a history of intracranial tumor, aneurysm or arteriovenous malformations; or a history of active peptic ulcer or active gastrointestinal (gi) bleeding within the past 2 months; or planned major procedure within 6 weeks; or known platelet count \< 100,000 /mm3 or hb \< 10 g/dl ce5. planned surgery which may cause discontinuation of adp-receptor antagonist ce6. other serious illness (e.g., cancer) that may reduce life expectancy to less than 1 year ce7. repeated mi within 7 days of hospitalization for acute mi * angiographic exclusion (ae) criteria (visual estimate) ae1. bifurcated lesion unable to identify the culprit lesion ae2. the culprit lesion is located in the left main artery. ae3. diffusive lesions without distinguishable culprit lesion ae4. previous stent implantation in the culprit lesion segment or stemi caused by stent thrombosis ae5. likely cabg procedure within 30 days

Keywords: st elevation myocardial infarction，
extruded the effectıveness of prone posıtıon ın ınfants evaluatıon

Conditions: Prone posıtıon

Summary: the aim of this study was to determine the effect of prone position on vital signs, arterial blood gases and blood values in 0-1 year old infants extubated after congenital heart surgery. the study was a randomised controlled experimental type study.

the sample of the study consisted of 40 infants aged 0-1 year who underwent surgery in the cardiovascular surgery intensive care unit of a private hospital.data collection tools consisted of "data collection form", "vital signs follow-up form", "arterial blood gas follow-up form", "blood values follow-up form" prepared by the researcher in line with the literature information and some measurement data used in the study (arterial blood sample obtained with the blood gas measurement device used in the nicu and blood gas parameters (paco2, ph, pao2, lac and sao2) and bedside monitor). the study was conducted in the cardiovascular surgery intensive care unit of a private foundation university hospital. infants between the ages of 0 and 1 year who had undergone congenital heart surgery and were extubated after surgery, who did not have any congenital anomalies of the lungs in addition to congenital heart disease, who did not have any condition that could affect cardiac, circulatory and respiratory functions or prevent positioning were included in the study. the infants to be included in the study were randomly selected to the control and study groups to avoid bias in the study. which of the experimental or control groups the infants included in the study would be in was determined by using the address "https://www.calculatorsoup.com".

Eligibility criteria:
inclusion criteria: * to be between 0-1 years old * having congenital heart surgery * endotracheal intubation has been applied * being extubated after congenital heart surgery * obtaining permission from their parents to participate in the study exclusion criteria: * in addition to the diagnosis of congenital heart disease, congenital heart disease of the lungs with any of the anomalies, * position that may affect cardiac, circulatory and respiratory functions or surgical intervention that prevents ecmo (open sternum bone, ecmo support, etc.) * complications developed during the study, * infants whose parents did not agree to participate in the study were included in the study. is not recognised.

Keywords: congenital heart diseases extubation newborn prone position
affective bonding in mothers and their premature newborn

Conditions: Premature Infant

Summary: this experimental study will determine the effectiveness of nursing intervention "the attachment promotion" to increase the affective bonds between mothers and their premature infants. the assignment of the mothers to the control group will receive usual care, the mothers will be assigned to intervention group will receive the intervention.

the premature newborn has a high need for positive interactions, which is a challenge for him, due to biological immaturity, and for his mother because of the level of stress that this situation generates. behavioral and developmental interventions are needed to address the unique behaviors of preterm infants and the interactive capacities of the mother-newborn premature dyad. the project will be conducted in 18 months. the assignment of the mothers to each group will be like that: first at all, mother will be assignment to control group. they will received usual care when achieve the total of 74 mothers, the mothers will be assigned to intervention group.

Eligibility criteria:
inclusion criteria: premature infant: * neonates who had been hospitalized in the neonatal care unit, with ages ranging from 29 - 36.6/7 weeks gestation at birth. * apgar to the minute and five minutes greater to 7/10 mother: * mother with nursing diagnosis: risk of impaired attachment. * mother with a neonate who had hospitalized in the neonatal care unit, with ages ranging from 29 - 36.6/7 weeks of gestation at birth * mother living in the metropolitan perimeter of the city of bucaramanga exclusion criteria: newborn: * infants that underwent surgery * infants with neurological injury. * congenital cardiac abnormalities, severe deformities, grade iii intraventricular hemorrhage. mother: * mother with limitations: hearing, motor and / or mental handicap-measured through the abbreviated mental test (minimental), that prevent the intervention. * mother consuming psychoactive substances. * with mental alterations, verified in the medical history.

Keywords: premature infant mother-infant interaction acoustic stimulation/methods touch visual stimulation vestibule, labyrinth/physiology
caval aorta index for fluid optimization in traumatic brain injury

Conditions: Fluid Balance

Summary: traumatic brain injury is a leading cause of death and disability in trauma patients. as the primary injury cannot be reversed; management strategies must focus on preventing secondary injury by avoiding hypotension and hypoxia besides, maintaining appropriate cerebral perfusion pressure, which is a surrogate for cerebral blood flow.

the caval aorta index is an ultrasound element, relatively new, used to assess volume status. technically, the sonographic assessment of the inferior vena cava /aorta diameter ratio is an easy test to perform and can be performed effectively by doctors who are not experienced in the field of sonography (kusumastuti et al .2021). in this study; the caval aorta index will be used to guide fluid dosage in critically ill patients with traumatic brain injury.

Eligibility criteria:
inclusion criteria: traumatic brain injury diagnosed by computed tomography scan glasgow coma score ≥ 4 exclusion criteria: inability to get consent. pregnant and lactating women traumatic subarachnoid hemorrhage spinal cord injury increased intra-abdominal pressure abdominal aortic aneurysm inferior vena cava (ivc) thrombus portal hypertension acute corpulmonale congestive heart failure chronic hemodialysis surgical intervention other than neurological one within the first 7 days mechanical ventilation need during first 7 days cardiac arrest during the first 7 days

Keywords: caval aorta index traumatic brain injury
gait speed for predicting cardiovascular events after myocardial infarction

Conditions: Myocardial Infarction

Summary: there are growing evidences that gait speed is inversely associated with all causes mortality especially cardiovascular mortality among the elderly. the purpose of this study is to evaluate the predictive value of gait speed for cardiovascular events in patients after st-segment elevation myocardial infarction (stemi).

the investigators will enroll patients capable of walking with stemi. all patients will receive successful reperfusion therapy within 12-hour from onset. gait speed during cardiac rehabilitation is measured. cardiovascular events were defined as a composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke, for an average follow-up period.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of st-segment elevation acute myocardial infarction * must be treated within 12 hours after symptom onset * must be able to walk * must receive successful primary percutaneous coronary intervention exclusion criteria: * history of prior myocardial infarction * cerebrovascular disease with residual hemiplegia * severe peripheral arterial disease

Keywords: myocardial infarction
the safety and efficacy of administrating diapep277® vaccination in type 1 diabetes patients.

Conditions: Type One Diabetes

Summary: type 1 diabetes is caused by an autoimmune process resulting in a selective destruction of the pancreatic insulin-secreting beta-cell. diapep277® is a small, lyophilized powder containing 24 amino-acids. we have proved in former studies that diapep277® can slow down beta cells destruction in the pancreas and therefore decelerate the progress of diabetes. the objective of the study is to assess the efficacy and safety of administrating diapep277® in type 1 diabetes patients.


Eligibility criteria:
inclusion criteria: 1. fasting c-peptide levels \>= 0.2nmol/l. 2. diagnosis of type 1 diabetes 3. no pregnancies or planned pregnancies of female subjects exclusion criteria: 1. the subject has any significant diseases or conditions, including psychiatric disorders and substance abuse that, in the opinion of the investigator, are likely to affect the subject's response to treatment or the ability to complete the study. 2. the subject has a history of any kind of malignant tumor (not including basal cell skin cancer). 3. the subject has clinical evidence of any diabetes-related complication that in the opinion of the investigator would interfere with the subject's participation in and/or completion of the study. 4. subject has history of endogenous allergic reactivity: * severe allergic reaction or severe exacerbation of allergic asthma within 12 months prior to the screening-ext visit. * ongoing systemic asthma treatment. * subjects with history of life threatening or severe allergy, re-occurrence of which cannot be ruled out based on the investigator's judgment. 5. the subject has known allergy to lipid emulsions. 6. the subject has a known immune deficiency from any disease, or a condition associated with an immune deficiency. 7. the subject is receiving immunosuppressive or immunomodulating agents or cytotoxic therapy or any medication that in the opinion of the investigator might interfere with the study. 8. the subject has any of the following clinically significant laboratory abnormalities: * alanine aminotransferase (alt) or aspartate aminotransferase (ast) greater than three times the upper limit of the normal (uln) at the screening-ext visit. * total bilirubin greater than 1.3 times the uln at the screening-ext visit. * subjects with severe renal failure at the screening-ext visit (as defined by glomerular filtration rate \< 30 ml/min/1.73 m2 by cockroft und gault calculation • clinically significant laboratory abnormalities, confirmed by repeat measurement, which may interfere with the assessment of safety and / or efficacy of the study drug, other than hyperglycemia and glycosuria at the screening-ext visit. * fasting triglycerides \<1000 mg/dl (11.3 mmol/l) at the screening-ext visit. suitable medical therapy for treatment of hyperlipidemia is allowed. 9. the subject is a known or suspected drug abuser. 10. the subject is known to test positive for hiv antibodies. 11. the subject has chronic hematologic disease. 12. the subject has liver disease such as cirrhosis or chronic active hepatitis.
a study to compare analyte levels in blood samples collected using the tap20-c device with results obtained by fingerstick

Conditions: Diabetes

Summary: this study will compare blood collection from the forearm using an investigational device tap20-c to blood collection from the fingertip.


Eligibility criteria:
inclusion criteria: * healthy subject group 1. male and female volunteers 18 years of age or older. 2. voluntary written consent to participate in this study. diabetic subject group 1. male and female volunteers 18 years of age or older. 2. have been diagnosed with type 1 or type 2 diabetes mellitus by self-report. 3. voluntary written consent to participate in this study. exclusion criteria: 1. subjects who are pregnant or nursing mothers by self-report. 2. subjects with a history of skin disorders or who present with abnormal skin integrity or atypical skin health within the areas to be tested. 3. subjects with a missing index or middle finger on either hand or a missing forearm 4. subjects who have known allergies to titanium.
patient registry of blind subjects with sleep-related problems

Conditions: Sleep-wake Disorder in Blind Individuals

Summary: non-24-hour sleep-wake disorder (non-24) is a condition experienced primarily by totally blind individuals that results in abnormal night sleep patterns and chronic daytime sleepiness. this is a research protocol to develop a patient registry of subjects who may suffer from non-24 and who are blind. subjects participate in the study through a phone survey. this registry will be used to better understand, sleep related problems in blind individuals, including the investigation of a potential treatment, recruitment for future clinical studies, and to provide a forum for raising awareness about non-24. the survey consists of questions regarding the degree of vision impairment and sleep problems that the subjects may be experiencing.


Eligibility criteria:
inclusion criteria: 1. subjects or legal guardians must be at least 18 years of age to participate in the telephone survey. parents or legal guardians may represent children from 0 through 17 years who meet the following criteria. 2. subjects must be blind. 3. subjects must have some self-described problem with sleep or daytime sleepiness.

Keywords: non-24 n24hswd blindness sleep wake circadian rhythm nap
comparing erector spinae and fascia iliaca blocks for pain relief after femur surgery, a randomized controlled study

Conditions: Analgesia Following Femur Surgeries in Adults

Summary: this clinical study compares two types of nerve blocks used to control pain in adult patients undergoing surgery on the upper (proximal) or middle (midshaft) part of the femur (thigh bone). the two blocks being studied are the erector spinae plane (esp) block and the fascia iliaca compartment (fic) block. both techniques are commonly used in hospitals to reduce postoperative pain. the goal is to determine which nerve block provides more effective pain relief, reduces the need for opioid medications, and supports faster recovery in patients following femur surgery. results from this study may improve pain management strategies for similar procedures in the future. adults scheduled for proximal or midshaft femur surgery may be eligible to participate. eligibility is determined based on clinical criteria reviewed by the study team.administration of one of the two nerve blocks before surgery.standard surgical and postoperative care. monitoring of pain levels at specific time points after surgery recording of opioid medication usage evaluation of patient satisfaction and any side effects related to the nerve block duration: the intervention (nerve block) is administered once before surgery. data collection continues during the immediate postoperative period and for a short time following surgery to assess outcomes. both nerve blocks are considered safe and are regularly used in clinical practice. all procedures are performed by qualified clinicians, and safety monitoring is conducted throughout the study. participants may experience improved pain relief and reduced need for opioid medications. while direct benefit cannot be guaranteed, information gained from the study may help improve pain management for future patients undergoing similar surgeries. participation in the study is completely voluntary. patients may choose not to participate or may withdraw from the study at any time without affecting the quality of their medical care.


Eligibility criteria:
inclusion criteria: * age 18-80 * american society of anathesiologist physical status asa ior ii * patients undergoing fixation of femur fractures exclusion criteria: 1. refusal of participation in study. 2. bleeding disorders (platelets count \&lt; 80,000, inr \&gt;1.5, prothrombin concentration \&lt; 60%). 3. skin lesion, wounds or infection at the puncture site. known allergy to local anesthetic drugs. 4. known local anesthetic (la) drug sensitivity. -

Keywords: fascia iliaca block, erector spinae block, femur fracture surgeris in adults, analgesia